Columbia University Medical Center (CUMC) contains several large research programs in basic cardiovascular research and clinical heart failure. In response to this P30 program, the Department of Medicine and the Cardiovascular Research Initiative (CVRI) have selected a recently recruited new faculty member whose tenure track appointment will begin on July 1, 2009. Our proposed new faculty member is completing his training in cardiology in the CUMC program, one of the most selective programs in the country. Prior to this he performed studies on the basic biology of skeletal muscle and its abnormalities in patients with heart failure. The proposed research includes clinical and basic studies of the effects of heart failure on muscle biology, concentrating on protein turnover and lipid metabolism. The central hypothesis of this application is that common gene expression patterns and metabolic derangements determine structural and functional changes in the skeletal muscle and myocardium of patients with heart failure, and that those changes are reversible after hemodynamic improvement through ventricular assist device placement. A series of senior collaborators at CUMC will assist in these studies. A career guidance program that includes faculty from several departments has been developed to insure the success of this recruit. Funds from this grant will support the purchase of equipment, provide operating expenses for the proposed clinical and basic research, and will allow the hiring of support staff to assist with the 2 year studies. The Department of Medicine and Division of Cardiology have committed additional funds that guarantee full salary support and some laboratory operating expenses for five years. A major goal of the Department and CVRI is to increase interaction between our clinical and research activities in cardiovascular disease. This recruitment is an effort to do that by adding an outstanding new faculty member focusing on translational research. Heart failure is an expanding worldwide epidemic that already affects more than 5 million people in the US. Exercise intolerance and muscle wasting result from impaired peripheral metabolism and are predictors of mortality in heart failure. This research aims to understand the fundamental interactions of skeletal muscle and myocardial metabolism and function with the ultimate goal of discovering new therapies to prevent or treat the functional decline in patients with heart failure.